Modelos de abordaje de las adicciones

Main ideas and concepts

1) Addictions and the need to choose an approach

• The speaker presents “addiction” as a topic with many existing educational and intervention approaches.
• They focus on three specific models used to address addiction:
  1. Legal–moral model
  2. Medical model
  3. Biopsychosocial model
• A key point is that no single model fully replaces the others. Professionals often select an approach based on:
  • what they feel comfortable using,
  • the person they’re working with,
  • and the stage of addiction.

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2) Legal–moral model

Core beliefs (as described)

• People begin consuming drugs by their own free will.
• Consumption is treated as a bad path resulting from the person’s decisions.
• It is characterized as:
  • self-destructive
  • immoral
  • harmful to society
• It is often tied to legal and social judgment, including treating users as dangerous or criminal.

Common consequences and examples

• Users may be criminalized or treated as suspects.
• The speaker describes cases where someone is stopped because they “look like” a drug user (e.g., marijuana use).
• A classic prevention tactic mentioned: “Live Without Drugs” (“Vive sin drogas”), using “before vs. after” imagery (wrinkles, acne, extreme thinness, and jaw problems associated with meth/crystal meth, etc.).
• The speaker notes that this approach can rely on fear campaigns, though its effectiveness is questioned.

Limitations highlighted

• Not everyone visibly deteriorates in the same way.
• Example: someone may be addicted (e.g., using clonazepam before sleep) yet remain functional and not show obvious physical decline.
• Fear-based “before/after” imagery may not capture the complexity of real cases.
• The speaker emphasizes that effectiveness depends on where and how the model is implemented.

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3) Medical model

Core beliefs (as described)

• Addiction is framed as a recurring and chronic brain disease.
• It involves compulsive seeking and use of drugs despite harmful consequences.
• The “disease” framing can be helpful for reducing internal stigma:
  • “I don’t want to be sick, I want to be well.”

Typical dynamics in this model

• Some people may deny their substance use.
• Medical framing may confront denial by pointing to:
  • physical deterioration
  • body pain
  • the idea that alcoholism/substance use is an illness

Authority sources and influence

• People may trust doctors more than other professionals (psychiatrists/psychologists), especially due to stigma.
• A family doctor/general practitioner is described as more likely to be trusted.

Limitations highlighted

• The speaker argues the medical model doesn’t advance enough on its own and has important limitations that must be examined for better addiction care.
• Alcoholics Anonymous is mentioned as sometimes using disease framing as well (though it may depend on the program leader).

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4) Biopsychosocial model

Core structure (explicitly stated)

• Addiction is approached by integrating three domains:
  • biological
  • psychological
  • social
• The speaker also describes an emotional dimension within the overall picture.

Why this model matters

• It aims to consider “the whole picture” when working with someone with an addiction.
• It is presented as especially comprehensive for counseling and intervention planning.

Biological dimension (examples)

• Genetic vulnerability is considered.
• Family-based examples include:
  • a child living with relatives (not their biological parents) whose family history includes substance use
• The speaker stresses caution:
  • genetic risk does not guarantee addiction, but it requires attention.
• A diabetes analogy is used:
  • family history can increase risk without guaranteeing illness if protective behaviors exist (diet/exercise).

Psychological dimension (mechanisms described)

• The environment can normalize substance use, shaping whether the person sees consumption as a problem.
• Conflict and coping are central:
  • if someone struggles with conflicts or manages stress poorly, they may have low frustration tolerance and seek immediate relief
• The speaker links this to behaviors that bring temporary relief or pleasure, not always “classic” drug use, such as:
  • video games
  • alcohol
  • coffee/soft drinks (as examples of short-term relief behaviors)

Social dimension (normalization and context)

• Social environments influence what’s seen as acceptable or harmful.
• In some places, consumption may be ritualized or culturally treated differently.
• Examples include drinking at:
  • gatherings
  • barbecues
• Social involvement may surround alcohol use.

Addiction pattern described in this model

Risk increases when a person:

1. seeks relief/pleasure through a behavior,
2. then faces negative consequences,
3. yet continues the behavior,
4. resulting in ongoing problems in work, social life, and family life.

• A warning pattern is specifically mentioned:
  • “I start drinking 1, 2, 3 beers and can’t stop” → suggesting a possible addiction issue.

Counseling stance and key guiding questions

• Counseling should focus on understanding circumstances, not judging morality or asking shallow “why” questions.
• The speaker contrasts question types:
  • wrong (too limited): “Why are you addicted?”
  • better: “Why the pain?” / “Why the suffering?”
• The goal is to gather information about:
  • what happened
  • why the person started using
  • why they are in their current state

Example counseling insights given

• A person reduces alcohol and reviews their life, answering “What is the problem?”
• The speaker contrasts surface-level explanations (e.g., “because I drink and can’t work”) with deeper biopsychosocial factors, such as:
  • identity issues
  • needing to please others
  • stress and anxiety
  • joining groups and consuming to fit in or due to pressure
• Recovery is framed as seeing the person holistically—not focusing only on genetics or moral choice.

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Methodology / approach instructions (as presented)

Although the video is not a step-by-step “how-to” manual, it offers counseling guidance via recommended inquiry.

Biopsychosocial counseling question framework

• Do not center the question on blame or simplistic causes:
  • Avoid: “Why are you addicted?”
• Instead, center exploration on suffering and underlying drivers:
  • Use: “Why the pain? Why the suffering?”
• Explore biographical and contextual contributors, such as:
  • stress/anxiety triggers
  • conflict resolution difficulties
  • identity/acceptance needs
  • social pressure and normalized substance environments
  • the sequence: temporary relief/pleasure → negative consequences → continued behavior

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Summary takeaway

• The speaker reviews three common addiction models and argues that each shapes how we interpret addiction and how professionals intervene.
• The biopsychosocial model is presented as especially valuable for counseling because it integrates:
  • biological vulnerability
  • psychological coping
  • social context
• The emphasis is on understanding the person’s suffering to support recovery.

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Speakers / sources featured

• Speaker (unnamed): The presenter/professional discussing the three models and giving examples (including references like “some patients have told me” and “my job is this”).
• Alant Alcoholics Anonymous (AA): Mentioned as commonly using a disease/medical framing of alcoholism/addiction.